Endometrial Hyperplasia and Chocolate Tumor Recurrence: The Importance of Continuous Treatment with Oral Progesterone

Menstrual pain troubles many women every month, but it has gradually become a habit. It turns out that heavy menstrual flow, long-term menstrual pain, or menstrual blood clots may be symptoms of endometrial hyperplasia, collectively known as endometriosis It is estimated that there are about 300,000 women in Hong Kong suffering from endometriosis without knowing it. By the time of diagnosis, the chocolate tumor may have become larger, and chocolate tumor surgery must be performed to remove it , Dr. Zhang Kaiqing, a specialist in obstetrics and gynecology, pointed out: “Estrogen in women can stimulate the growth of chocolate tumors. Oral hormone drugs such as progesterone can reduce estrogen levels and reduce the growth of endometriosis.” As long as women still menstruate , there will be a risk of recurrence at any time, and only continuous medication until menopause can effectively prevent recurrence.

Menstrual pain is a warning signal Oral hormone drugs control chocolate tumor

Rachel, a 36-year-old patient with endometriosis, was troubled by long-term menstrual pain, but she didn’t take it seriously. She kept taking ordinary painkillers to relieve the pain, until she became dizzy and vomited after a meal. She was admitted to the hospital and finally found endometrial hyperplasia. Endometriosis required immediate chocolate tumor surgery to remove the tumor with a diameter of 11 cm. After that, Rachel began to take oral hormone drugs to control the condition. Rachel, who resisted taking drugs on weekdays, said: “If the baby is born with tenth grade pain, menstrual pain will also have pain.” Level 7 pain, you must take medicine to alleviate the condition, at least you can have a normal life.”

In fact, as long as early detection and hormonal drug treatment is used to control the disease in mild to moderate cases, such as oral progesterone, contraceptive pills, contraceptive injections or menopausal injections, etc., not only can relieve menstrual pain, but also have the opportunity to slow down the endometrium hyperplasia, or stop the cyst from getting bigger. Dr. Zhang Kaiqing, a specialist in obstetrics and gynecology, pointed out that if the chocolate tumor is not larger than 4-5 cm and there is no sign of bursting, patients with endometriosis can take oral hormone drugs for a long time until menopause, the condition can be controlled, and there is even a chance to be exempted. Chocolate tumor surgery. “

Continued treatment to prevent relapse Long-term medication does not affect fertility

In addition to chocolate tumor surgery, oral hormonal drugs can also control and inhibit endometriosis, and the side effects of the new generation of progesterone are lower than menopausal injections, which can effectively reduce menstrual pain and control endometrial hyperplasia. Continuous treatment can effectively reduce chocolate Tumor recurrence. Many women mistakenly believe that oral hormone drugs will affect their fertility. In fact, the new generation of progesterone drugs will be metabolized within a few days, excreted through urine, and will not accumulate in the body. Clinical studies have confirmed that menstruation will return to normal within about 2 months after stopping taking it, so it will not affect future conception, pregnancy or fetal development. Dr. Zhang reminded: “In the absence of drugs to control endometrial hyperplasia, the chance of recurrence is very high, and the process will continue to cycle, even if the chocolate tumor is removed. Relapse within a year, and half of the patients relapsed within five years of stopping the drug. As long as women still menstruate, there is a risk of recurrence at any time. Unless it is not for family planning or menopause, it is generally not recommended for endometriosis patients to stop taking drugs.”

There is a risk of stopping the drug to prepare for pregnancy. Make a timetable to reduce the chance of recurrence

Endometriosis is a long-term disease. Oral hormonal drugs such as progesterone can reduce estrogen levels and reduce the growth of endometriotic tissue. The drug will not be stopped until menopause or pregnancy is planned. Long-term medication will not affect fertility On the contrary, if no medication is used at all, the patient’s ovary and pelvic cavity will be in a state of chronic inflammation for a long time because of the chocolate tumor, which will make it difficult for the embryo to implant in the uterus, thus affecting fertility. Therefore, doctors generally advise patients to take advantage of the two-year golden period after stopping the drug to prepare for pregnancy, and to avoid the recurrence of chocolate tumors and affect fertility. At that time, Rachel had to stop taking the medicine because of her family planning. She had to race against time every day. She was faced with the psychological pressure of not being able to conceive naturally. Unfortunately, Rachel’s chocolate tumor recurred within two years after stopping the medicine, and she was again tortured by intensified menstrual pain. Rachel finally chose artificial insemination and successfully gave birth to her daughter. Dr. Zhang added that chocolate tumors will gradually increase with each menstrual cycle. Patients with endometriosis must receive continuous drug treatment after giving birth and stopping breastfeeding to slow down the growth of cysts and Enlarged, or even shrunk, until the patient stops menstruating, reminding that endometriosis is a chronic disease, and patients should not ignore the necessity of taking medicine.